13 weeks, measuring a week and a half behind - UPDATE

Thanks so much for the thoughts and prayers. We had our follow up ultrasound today and it didn't go well :(

We were finally able to get the nuchal measurment which came out fine, but my blood work shows extrememly low HCG and Papp-A. That coupled with the small measurments come with a very high liklihood of a chromosome problem. The two most likely are Trisomy 18 and Triploidy. Both are fatal conditions. I have an amnio scheduled in 2 weeks with results back 4 days after that. There's a very low likihood of everything coming back okay, so at this point we have to prepare for the worst.

If I hear one more time that babies can measure small and they're probably fine, I'll scream. There's more to it than that at this point and as much as I try to think positive, there's not a lot of reasons to be optimistic at this point.

It's not impossible for the tests to come back okay, but the doctor was pretty realistic with us and that's probably not going to be the case. They said that if they come back without chromosome problems, we'll be sent for genetic testing because it will likely be some other abnormality.

It's been a tough week and we're in for a few more tough weeks, but there's nothing we can do except wait

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Hi Ladies,

I'm new to this board.. here's my story...

I am 34 years old. I had a miscarriage on November 6 at 6 weeks. I was pregnant again 4 weeks later with no cycle in between. My doc sent me for a 5 week ultrasound for dating and we saw 2 gestational sacs. We were sent back at 7 weeks to confirm that we are in fact having twins. I had another ultrasound at 8.5 weeks due to spotting and everything looked good. The 5 week scan measurements were right on track with my ovulation date (known from charting). The 7 and 8.5 week ultrasounds were a couple of days off from the 5 week, but nothing alarming.

So last Thursday (feb 3) we went for our NT scan. Based on previous ultrasounds, I should have been anywhere from 11 weeks, 4 days to 12 weeks. The best crown to rump measurment they could get was 10 weeks, 6 days (but their heads were measuring 12 weeks). Since they were measuring smaller, they couldn't get a good measurement for the Nuchal and I was scheduled to come back in a week....

So fast forward to this past Thursday, we went for the NT scan again. Both heads were now measuring 13 weeks, but the crown to rump was only measuring 11 weeks, 3 days (only 4 days growth in a week). We were there for 2 hours with constant scanning to try to get a better crown to rump measurement. The doc finally came in and tried to scan himself and didn't have any more luck than the ultrasound tech. They couldn't get a decent measurement for the nuchal again, so we go back in another week.

Both babies heart rates are good and the doctor said that they look fine and he doesn't see anything that is raising red flags other than their crown to rump measuring small. Both babies are measuring the same. If they are still small next week then they are sending me for a CVS that day (which is confusing since I thought it could only be done up to 12 weeks). The doc said not to worry but of course I still probed as to what could be wrong if they don't catch up. He said there is the possibility of chromosome problem. Now all we can do is wait until next week. I'm trying not to worry, but if you look at my ultrasound history below, it's worrisome, because each ultrasound they fall a little more behind than the last.

Ultrasound history, dates based on the first ultrasound and ovulation date from charting:

So I guess my reason for being here is to see if anyone who has gone on to receive worrisome news has experienced the same thing with the small crown to rump measurements. Everything I've read says that IURG doesn't happen until later in the pregnancy and if they continue to fall behind week by week yet their heads continue to grow at a normal rate will likely indicate a chromosome problem. Any help or advice would be greatly appreciated.

Comments (14)

I'm not sure I can offer any positive news, but I can share our story. I was pregnant in 2009 and across the board was "normal" and "low risk." At our 20-week u/s the doctor saw something called a choroid plexus cyst (CPS). In combinatoin with the fact that they couldn't see some of the baby's organs b/c of how she was laying, they referred us to a level 2 u/s. CPS can sometimes be an indicator of chromosomal abnormalities, but also occur in normal pregnancies. The level 2 was normal, my bloodwork was normal, and the next two follow up u/s were normal. Our daughter was always measuring between a week and a week and a half behind, but within the range of normal. When I was about 29 weeks pregnant, other things showed up and we decided to have an amnio because too many red flags had appeared. Our daughter had full Trisomy 18 and passed away three days after she was born. I don't blame any of the doctors, because all of the information they had indicated that we didn't have a problem, until late in the pregnancy. If you're looking for advice, I guess I'd say this: information is power. If a CVS or an amnio is offered, I would probably do it (and we will in any future preganancies) because it will answer any concerns or questions you may have. I hope very much that everything in your pregnancy goes on to be proglem-free and turns out just the way you had imagined!

Thanks for sharing your story.. I'm so sorry about the loss of your daughter. I agree with you, we'll do any testing that we are offered. Regardless of what decision we would make, we feel it's better to know and be prepared. Trisomy 18 is the one abnormality that we have found where the fetus will measure small in the first trimester. Fingers crossed that both of our little beans are okay.

I don't really have any positive news to report either, and I don't want to make you worry any more than I know you already are. Our baby consistently measured about 5 days small throughout the PG until the last few weeks, where he basically stopped growing altogether and he was about two weeks behind when he died. That said, until the abnormal NT scan, NO doctor indicated that his slower growth was a problem, which indicates to me that it can be entirely normal for a baby to be a little slow growing. So, I'd stick with that for now, and only worry when you have to. I know, easier said than done. Hang in there, and keep us posted!

I am so sorry you are dealing with this very scary news. I haven't been in your exact position but have waited out 1:21 risk for DS to find out at birth that our boy had typical chromosomes. I worried myself literally sick. I researched internet like crazy and every time I found something bad remotely relevant my stomach and hart would just flip, convinced it was about my baby. My advice for you is to stop searching internet for studies that most likely are not relevant to you.

Try to focus on the fact that they are growing and doc didn't see any red flags. Babies grow at different rates especially twins. Are they still within the 'normal range' - ie smaller than the avg for 13wks but within norm? Worth asking about? Is your placenta working fine? I don't know much about placenta issues and whether they can manifest themselves so early, but perhaps worth asking about too? And in general perhaps worth asking what else can it be apart from chromosomal issues - ie could it be that your babies are just small?

I hope you get some good news next time. Will keep my fingers crossed for you!

Thanks... I know that I should stay off of google, I think I've searched all I can, so I'm just waiting now. Our ultrasound is tomorrow and I will ask more questions. The doctor said that they're not too far out of the normal range yet, but that it's concerning they they fall further behind each week. At 13 weeks, I was measuring 11 w 3 d which is over 20mm. I read an article that said the following. We'll know more tomorrow... I'll keep you posted... fingers crossed for my little beans!

FIRST-TRIMESTER ULTRASONOGRAPHIC ABNORMALITIES

Fetal Growth Restriction

The study of large groups of first-trimester fetuses has shown that lethal chromosomal abnormalities can be associated with a small-for-date CRL as early as 9 to 10 weeks of gestation.5,6When the CRL is shorter than the normogram for the gestational age by 14 mm or more, there is a high risk of certain trisomies.6 This risk rises twofold when the CRL is smaller than the normogram by at least 7 days.5 However, most fetuses affected by trisomy 21 or sex-chromosome abnormalities have a normal intrauterine growth pattern.6 In rare cases, placental anomalies detected on ultrasonography may be associated with fetal growth restriction as early as 12 weeks' gestation.

Just wanted to give you ladies an update. We had our amnio today and will receive the Fish results on Monday, however when they did the ultrasound, they were able to see severe abnormailities in their brain development. We won't know the actual diagnosis until Monday, but either way, it won't be compatible with life. They've scheduled the termination for Tuesday and Wednesday. :( Thank you all so much for your support.